State Highlights: Calif. Bill Advanced To Address Doctor Network Concerns; KanCare May Go Without IG
A selection of health policy stories from California, Kansas, New York, Pennsylvania, Texas, Iowa, New Hampshire, New Mexico and Florida.
Los Angeles Times:
Health Insurers May Face Tougher Rules On Obamacare Doctor Lists
In response to complaints about Obamacare doctor networks, a California lawmaker and three consumer groups are seeking legislation that would require health plans to improve provider directories. State Sen. Ed Hernandez (D-West Covina) said Friday he introduced legislation that would force health plans to update their provider lists weekly and make them more widely available online to insurance shoppers. (Terhune, 1/23)
The Kansas Health Institute News Service:
Mosier: KanCare May Not Need An Inspector General
The state official who heads KanCare said Friday that the Medicaid program’s long-vacant inspector general position may not need to be filled. The KanCare inspector general would serve as a watchdog over the $3 billion contracts the state awarded to three private insurance companies to administer Medicaid services. Susan Mosier, secretary of the Kansas Department of Health and Environment, told a legislative committee Friday that the state is struggling to find a qualified candidate who will take on the job. (Marso, 1/24)
The New York Times:
To Collect Debts, Nursing Homes Are Seizing Control Over Patients
Few people are aware that a nursing home can take such a step. Guardianship cases are difficult to gain access to and poorly tracked by New York State courts; cases are often closed from public view for confidentiality. But the Palermo case is no aberration. Interviews with veterans of the system and a review of guardianship court data conducted by researchers at Hunter College at the request of The New York Times show the practice has become routine, underscoring the growing power nursing homes wield over residents and families amid changes in the financing of long-term care. In a random, anonymized sample of 700 guardianship cases filed in Manhattan over a decade, Hunter College researchers found more than 12 percent were brought by nursing homes. Some of these may have been prompted by family feuds, suspected embezzlement or just the absence of relatives to help secure Medicaid coverage. But lawyers and others versed in the guardianship process agree that nursing homes primarily use such petitions as a means of bill collection — a purpose never intended by the Legislature when it enacted the guardianship statute in 1993. (Bernstein, 1/25)
The Philadelphia Inquirer:
Program Glitch Wrecks Chaos For Addiction And Alcohol Treatment Providers In Pa.
A year before Healthy Pennsylvania's rollout, Michael Harle, president and CEO of Gaudenzia, the drug and alcohol treatment center, was assured by top state Medicaid officials his clients would not see their health insurance change. After Medicaid recipients began shifting to the new program on Dec. 1, "all hell broke loose," Harle said. A glitch in the system covered his clients and thousands of people across Pennsylvania in need of substance-abuse and mental-health services with private insurance instead of Healthy Plus, the new program for the medically frail. The problem is most of those private plans don't offer addiction and mental-health treatment, and those that do have less robust benefits than Healthy Plus. The result is thousands of people have been locked out of treatment centers, risking their lives, said Deb Beck, president of the Drug and Alcohol Service Providers Organization of Pennsylvania, a statewide coalition of treatment programs. (Calandra, 1/25)
The Texas Tribune:
HHSC Ditching Anti-Fraud Initiative Started By Stick
When Jack Stick became the deputy inspector general of the Texas Health and Human Services Commission in 2012, he saw an opportunity to help investigators beef up their production in bringing potential fraud cases forward. For the first time, general investigators — who review whether recipients of food stamps, Children’s Medicaid and other programs were overpaid — had to produce cases totaling at least $35,000 each month. For those investigating Medicaid overpayments to health care providers, cases had to be completed within 16 weeks — some cases had previously languished for years — unless they could show more time was needed. (Langford, 1/24)
The Des Moines Register:
Branstad Plan To Shut Mental Hospitals Called Illegal
Gov. Terry Branstad’s plan to unilaterally shut down mental health institutions here and in Clarinda is illegal, legislators charged Saturday. Sen. Rich Taylor told about 100 people at a community forum that state law specifically requires Iowa to have mental health institutions at Mount Pleasant, Independence, Clarinda and Cherokee. (Leys, 1/24)
The Des Moines Register:
Iowan Not Alone In Home-Health Concerns
A West Des Moines quadriplegic's complaint this month of being abandoned by a home-health care agency gave rise to new complaints to the Watchdog — and underscored a worsening national problem in a notoriously low-wage industry. Michael Penniman said his hope in making public concerns with Iowa Home Care in a Jan. 11 column was to give a voice to others he said were being ignored by the home-health care provider. (Rood, 1/25)
The Associated Press:
Health Department To Cut $7M In Nursing Home Funding
New Hampshire nursing homes could lose $7 million in expected Medicaid reimbursements as part of a plan to close a $58 million budget hole in the state's Department of Health and Human Services. Members of a joint legislative fiscal committee strongly opposed the cuts, but the changes do not require approval from legislators. (Ronayne, 1/23)
Stateline:
States Look To Tax E-Cigarettes
With an eye on the twin concerns of public health and raising revenue, Utah is one of many states considering taxing electronic cigarettes, the battery-powered devices that deliver vaporized nicotine and provide the look and feel of smoking without the smoke and tar of traditional tobacco products. Gov. Gary Herbert, a Republican, sparked this year’s debate when he included a footnote in his budget counting on $10 million from taxing e-cigarettes. (Povich, 1/23)
The Associated Press:
State May Release More Information On Health Services Audit
[New Mexico] Attorney General Hector Balderas on Friday said he’s researching the possibility of releasing more information from a 2013 audit of 15 nonprofits that provided behavioral health services for needy New Mexicans. Balderas told lawmakers during a House committee meeting that a decision was expected within a matter of days. The New Mexico Foundation for Open Government sued last September after former Attorney General Gary King’s office and the Human Services Department refused to release the audit. King had defended the secrecy of the audit, saying it was evidence related to an open investigation. (1/23)
Health News Florida:
Heroin ODs Spike After Pill Mill Crackdown
Five years ago, Florida was labeled the prescription drug capital of the U.S. Seven people died every day from overdoses – until the Florida Legislature started a crackdown. The Prescription Drug Monitoring Program made opiate pills more expensive on the street, and left many addicts with a choice: Get treatment, or find a substitute. But there’s a downside in the drop in prescription drug use. Overdoses and deaths from heroin are on the rise in Florida. In 2010, 48 people died from heroin overdoses. (Aboraya, 1/23)